Background: Tibialis posterior tendon, deltoid ligament and spring ligament are the three most important structures on the medial aspect of the foot. They contribute to the stability of the foot and ankle and also to the maintenance of the arches of the foot. These structures get affected and dimensions get disrupted in various traumatic and degenerative conditions. Normal range of dimensions of these structures has not been studied in an Indian population. Our objective is to define the normal thicknesses of these structures using a cadaveric model. We also hypothesize that longer the foot, higher stresses on these structures and hence thicker they will be. We aim to assess this hypothesis as well.
Methods: Dissection of the medial aspect of the foot was done on twenty cadaveric below knee specimens. Tibialis posterior tendon was identified and its thickness was measured. Deltoid and plantar calcaneonavicular ligaments were identified. Their lengths and thicknesses were measured. Length of the feet was also measured prior to dissection. Statistical analysis was done using the data obtained.
Results: Mean tibialis posterior thickness was 7.0165 ± 0.387 mm. Mean deltoid thickness was 5.124 ± 0.28 mm. Its mean length was 21.328 ± 2.22 mm. Mean plantarcalcaneonavicular ligament thickness was 2.491 ± 1.120 mm. Thicknesses of the tibialis posterior tendon and plantarcalcaneonavicular ligament correlated significantly with the length of the foot.
Conclusion: The thicknesses of the tibialis posterior tendon and plantar calcaneonavicular ligament are shown to be a function of and significantly proportional to the length of the foot. This helps the surgeon to estimate the thicknesses which the structures had prior to the pathology, in order to recreate the non-pathological anatomy after a tendon transfer or a reconstruction procedure. The normal thicknesses of tibialis posterior, deltoid and plantar calcaneonavicular ligaments are described for an Indian setting and deviations can be used to assess various pathologies of the foot and ankle affecting these structures.
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http://dx.doi.org/10.1016/j.jcot.2023.102252 | DOI Listing |
Iowa Orthop J
January 2025
Department of Orthopedics, Lifeline Multispecialty Hospital, Adoor, India.
Tarsal tunnel syndrome (TTS) refers to compression of the posterior tibial nerve as it traverses the tarsal tunnel in the ankle. First described by Keck and Lam in 1962, TTS is an underdiagnosed cause of heel pain and foot dysfunction. The tarsal tunnel contains the tibial nerve, posterior tibial artery, and tendons of the tibialis posterior, flexor digitorum longus, and flexor hallucis longus muscles.
View Article and Find Full Text PDFJ Brachial Plex Peripher Nerve Inj
January 2025
Department of Hand, Plastic, Reconstructive and Burn Surgery, BG Klinik Tuebingen, University of Tübingen, Tübingen, Germany.
Foot drop is a challenging condition that significantly impacts the affected patient's mobility and quality of life. Tendon transfer has emerged as a viable treatment option. We hereby present data of the tendon transfer procedures in patients with foot drop in our department.
View Article and Find Full Text PDFJ Chiropr Med
December 2024
Logan University, Chesterfield, Missouri.
Objective: The purpose of this case study was to report the management of a patient with posterior tibialis tendon injury concurrent with gender-affirming hormone therapy (GAHT).
Clinical Features: A 31-year-old transgender male presented to a chiropractic clinic with spontaneous, right medial foot pain following running that day. Medical history revealed bilateral congenital pes planus and intramuscular administration of testosterone for 8 years.
Toxins (Basel)
November 2024
Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37100 Verona, Italy.
Clonus is characterized by involuntary, rhythmic, oscillatory muscle contractions, typically triggered by rapid muscle stretching and is frequently associated with spastic equinovarus foot (SEVF), where it may increase risk of falls and cause discomfort, pain, and sleep disorders. We hypothesize that selective diagnostic nerve block (DNB) of the tibial nerve motor branches can help identify which muscle is primarily responsible for clonus in patients with SEVF and provide useful information for botulinum neurotoxin type A (BoNT-A) treatment. This retrospective study explored which calf muscles contributed to clonus in 91 patients with SEFV after stroke (n = 31), multiple sclerosis (n = 21), and cerebral palsy (n = 39), using selective DNB.
View Article and Find Full Text PDFArthroscopy
December 2024
Department of Orthopaedic Surgery, Chonnam National University Hwasun Hospital, College of Medicine, Chonnam National University, Seoyang-ro, Hwasun, Republic of Korea. Electronic address:
Purpose: To compare graft remodeling, as measured by magnetic resonance imaging (MRI), and clinical outcomes between patients who underwent isolated anterior cruciate ligament reconstruction (ACLR) versus combined anterior cruciate ligament and anterolateral ligament reconstruction (ACLR + ALLR).
Methods: A retrospective review was conducted on patients who underwent primary ACLR with quadruple hamstring grafts between January 2019 and March 2022, with a minimum follow-up period of 2 years. Patients were categorized into 2 groups on the basis of the addition of ALLR with tibialis anterior allografts: an isolated ACLR group and an ACLR + ALLR group.
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